| NPI | 1770705998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARTER LANE Orthodontist 909-888-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 247274) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |